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Inflammation: Blessing and Curse


Based on visual observation, ancient healers described inflammation by the presence of five predictable signs:

 

Redness - Due to increased blood flow to the area

Swelling (Edema) -  Due to increased passage of blood and lymphatic fluid into the surrounding tissues, infiltration of specialized immune cells into the damaged area, and in cases of prolonged inflammatory responses, the development of scar tissue.

Heat - Due to increased blood flow to the area.

Pain - Due to the direct effects of immune mediators (inflammatory cytokines) and the stretching of sensory nerves caused by the swelling.

Loss of Function - Refers to simple loss of mobility in a joint (from pain and swelling) or to the replacement of functional cells with scar tissue.

 

Although in ancient times it was recognized as being part of the healing process, up until the end of the 19th century, inflammation was viewed as being an undesirable response that was harmful to the host. Since then, we have come to appreciate the crucial role inflammation plays in protecting the body from injury as well as its destructive role in chronic illness.  We know today that inflammation is far more complex than it might first appear, and that it is intimately tied to the immune system s response to injury or infection.

 

Scope of Inflammation


The scope of inflammation ranges from classic inflammation described above in response to trauma to acute inflammation (S. aureus infection of the skin resulting in a boil) to chronic inflammatory processes (remodeling of artery walls in atherosclerosis, the bronchial wall in asthma and chronic bronchitis, or the debilitating destruction of joints with rheumatoid arthritis).

 

Complexity of Inflammation


The inflammatory process involves the major cells of the immune system, including neutrophils, basophils, mast cells, T-cells, and B-cells, all regulated in such a way as to ensure that exactly the right cells are recruited.  These events are controlled by a host of extracellular regulators including cytokines (interferons), growth factors (TNF), eicosanoids (prostaglandins, leukotrienes, etc.), complement and peptides, most of which have only been discovered in the last twenty years. 

 

Inside the cell there is an equally bewildering array of complex signaling pathways that move from inactive to dedicated roles within the inflammatory response.  Which cells and mediators come into play depends on a wide range of factors, including the root cause (type of pathogen, autoimmune, chemical or physical injury, etc.), the tissue or organ involved, and whether the inflammation is of an acute (resolving) or chronic (non-resolving) form. 


These cells are powerful defensive agents of the body, but the toxins they release (including reactive oxygen species) are injurious to the organism's own tissues as well as invading agents. This is why chronic inflammation is almost always accompanied by tissue destruction.

 

War is the Metaphor For Inflammation 


Both are necessary evils. Both are more or less stereotyped responses to outside threats. There are specialized troops (white cells), including suicide-commandos (neutrophils), long-term siege armies (granulomas), and many others. There are supply routes (vessels), communications and intelligence (mediators), and a huge array of lethal weapons (inflammatory enzymes). In war as in inflammation, there will be damage to both the enemy and to friendly forces, and there will very likely be severe damage to the battlefield itself.


Despite idealistic rhetoric about "the laws of war", when the fighting starts, there is really only one law for the soldiers: "Kill your enemy." Like it or not, if you want peace, you must be prepared to fight under certain conditions. Like it or not, if you want to be healthy, your body must be able to mount an inflammatory response.


Force will always rule our world. Our best hope is that this will be the force of good laws. And the best for which we can hope from the inflammatory response is that, for most of our lives, it will do us more good than harm.  Most likely, however, your own death will be caused by your last inflammatory response.

 

Markers of Inflammation 


Some of the common markers of inflammation include C-Reactive Protein (CRP), homocysteine and fibrinogen, all of which are important indicators of sudden cardiac event risk. These and other markers such IL6, histamine, and WBC's also measure the body's response to infection.

 

Outcomes of Inflammation


Various outcomes of inflammation may be expected. Resolution of the pathogenic threat is certainly the desired outcome.  However, connective tissue scarring, abcess formation, and ongoing or chronic inflammation is all too often seen in Americans today.

 

Pharmaceutical Treatment


Prescriptions can offer effective symptom management, but typically with nasty side effects.  That being said, they may offer the best hope for finding ways to relieve a genetic inflammatory condition.

 

NSAIDS (Aspirin, Naprosyn, Vioxx, Celebrex) inhibit the enzyme cyclo-oxygenase (COX1 and/or COX2) which lowers inflammation and pain, but they also cause erosion of the gastric membranes and can disrupt blood clotting mechanisms resulting in sudden heart attack.


Glucocorticoids reduce inflammation (but not pain) by directly inhibiting leukocyte function.  High dosages are required for efficacy, so topical use is best to minimize side effects.

 

Natural Strategies to Combat Inflammation  

 

Thymus Support - Thymus glandular extracts restore integrity to the immune system by nourishing the conductor of the orchestra , the thymus gland, and providing support to "central intelligence".   Antioxidants, vitamins and minerals neutralize free radicals and fuel mediators to inflammatory pathways.

 

Proteolytic Enzymes are often prescribed in Europe as a natural alternative to NSAIDS for controlling pain and inflammation.  Systemic enzymes have powerful direct anti-inflammatory effects as a result of their influence on immune cells, but also because of their role in "cleaning up the battlefield".

 

Liver Support - Today more than ever, our bodies are under siege, inside and out.  Inflammation greatly increases the toxic burden on the liver, which is all the more troubling given that the liver is responsible for synthesizing or recycling the vast majority of proteins that regulate signaling pathways for inflammation.

 

Probiotics - The beneficial bacteria in our gut directly reduce systemic inflammation that originates from the GI tract (which is a large percentage).

 

Essential Fatty Acids (especially omega 3 fats ALA, EPA and DHA and the omega 6 fat GLA) normalize the lipid profile, inhibit the release of leukotrienes and other cytokines, and provide building blocks for prostaglandins that stabilize inflammatory pathways.

 

Quercetin is a natural anti-histamine (without side effects), and pantothenic acid (Vitamin B-5) provides nourishment to adrenal glands to support natural anti-inflammatory pathways.

 

Lifestyle avoidance of chemicals and other toxins is critical to preventing and managing chronic inflammation.  Chelation therapy may be helpful in reducing ones toxic burden and thereby reducing the ongoing stimulus for inflammation.